Portal de investigação
Cost-effectiveness analysis of house dust mite allergen immunotherapy in children with allergic asthma
Autores da FMUP
Participantes de fora da FMUP
- Farraia, M
- Paciência, I
- Mendes, FC
- Rufo, JC
- Shamji, MH
- Agache, I
Unidades de investigação
Abstract
Background Cost-effectiveness studies evaluating allergen immunotherapy (AIT) in children are limited but needed to drive clinical and policy-making decisions such as reimbursement of new interventions. In this study, we compared the cost effectiveness of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) tablets to the standard of care (SOC) treatment in children with house dust mite-driven (HDM) allergic asthma. Methods We developed a hypothetical Markov model based on the Global Initiative for Asthma (GINA) severity steps to compare the three strategies over a 10-year horizon divided by cycles of 6 months. SOC was used as a reference to calculate the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were used to assess models' uncertainty. Other scenarios were evaluated to strengthen the presentation of results. Results The ICER for SCIT and SLIT tablets was 1281euro and 7717euro, respectively. The cost-effectiveness threshold for Portugal was 1,848,280euro; both treatment approaches were below this limit. The major contributors to these results were the AIT effects on reducing moderate and severe exacerbations and asthma controller medication. In the sensitivity analysis, SCIT revealed a higher probability of cost-effectiveness than SLIT. When including allergic rhinitis as comorbidity, ICER values reduced markedly, especially for SCIT intervention. Conclusions AIT was cost effective in children with HDM-driven allergic asthma, especially when given by the subcutaneous route. The high probability of cost effectiveness, especially for SCIT, may drive future policy decisions and AIT-prescribing habits. AIT adherence greatly influenced the results highlighting the value of implementing strategies to promote adherence rates.
Dados da publicação
- ISSN/ISSNe:
- 0105-4538, 1398-9995
- Tipo:
- Article
- Páginas:
- 2688-2698
- DOI:
- 10.1111/all.15321
- Link para outro recurso:
- www.scopus.com
ALLERGY Wiley-Blackwell Publishing Ltd
Citações Recebidas na Web of Science: 4
Citações Recebidas na Scopus: 10
Documentos
- Não há documentos
Filiações
Keywords
- allergen immunotherapy; asthma; children; cost effectiveness; house dust mites
Campos de estudo
Financiamento
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Citar a publicação
Farraia M,Paciência I,Mendes FC,Rufo JC,Shamji MH,Agache I,Moreira A. Cost-effectiveness analysis of house dust mite allergen immunotherapy in children with allergic asthma. Allergy. 2022. 77. (9):p. 2688-2698. IF:12,400. (1).
